Healthcare Provider Details

I. General information

NPI: 1952214389
Provider Name (Legal Business Name): JOHNNY HITE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 N 84TH PL
SCOTTSDALE AZ
85257-4142
US

IV. Provider business mailing address

1021 N 84TH PL
SCOTTSDALE AZ
85257-4142
US

V. Phone/Fax

Practice location:
  • Phone: 615-738-0440
  • Fax:
Mailing address:
  • Phone: 615-738-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberD09854348
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: